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Boyden's triad: the past, present and future.

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Boyden's triad, a rare B3 downwards-shifting malformation, was identified in 14 patients. This study details its types, incidence, and the first segmentectomy for this condition.

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Area of Science:

  • Thoracic Surgery
  • Pulmonary Anatomy
  • Congenital Lung Malformations

Background:

  • Boyden's triad, or B3 downwards-shifting malformation, is a rare congenital anomaly of the bronchus.
  • Understanding its anatomical variations is crucial for surgical planning.

Purpose of the Study:

  • To report 14 cases of B3 downwards-shifting malformation in the right lung.
  • To describe the bronchovascular patterns associated with this malformation.
  • To document the first successful segmentectomy for this condition.

Main Methods:

  • Retrospective analysis of 2356 patients with pulmonary lesions.
  • Utilized three-dimensional computed tomography bronchography and angiography (3D-CTBA) for detailed anatomical assessment.
  • Identified and classified 14 cases of B3 downwards-shifting malformation.

Main Results:

  • The incidence of B3 downwards-shifting malformation was 0.6%.
  • Three types were identified: normal downwards-shift (8/14), partial downwards-shift (5/14), and over downwards-shift (1/14).
  • Specific bronchovascular variations, including bifurcated right upper lobe bronchus, were noted in several cases.

Conclusions:

  • B3 downwards-shifting malformation is a rare anomaly requiring detailed anatomical understanding.
  • The findings provide insights into the variations of this malformation and support surgical intervention.